Stanford University Medical Center has a team of Arteriovenous malformation (AVM) experts, including neurosurgeons, interventional neuroradiologists, neurologists, nurse specialists and social workers who have worked together for many years and have treated over 2,000 patients from all over the world. They use a collaborative approach to offer the safest, most advanced treatment for patients with brain and spine AVMs. The team meets each week to discuss treatment options for AVM patients who send cases from all over the world.
What is an AVM?
Arteriovenous malformation (AVM) is an abnormal cluster of blood vessels in the brain or spine that can cause devastating neurological symptoms or even death. Normally, blood is carried to the brain through arteries and emptied through veins. Between the arteries and veins are capillaries that help decrease the pressure of the returning blood to the veins and back to the heart.
When someone has an AVM, they have no capillaries and some of their blood goes into the veins too early and under high pressure. This can cause a progression of symptoms that can lead to permanent disabilities or death.
What causes an AVM?
There is no known specific cause for most AVMs. It is believed that most people who have AVMs are born with them. They can occur in many locations throughout the brain and spine. They are not usually a hereditary disease. AVMs can sometimes develop after a head or spine trauma. These traumatic AVMs may also called AV fistulas.
Symptoms of AVMs
The most common presenting symptom for patients with an AVM is brain hemorrhage. In addition, patients can have:
- seizures
- headaches
- progressive neurological symptoms such as weakness and difficulty with speaking or swallowing
- Intellectual functions, such as short or long term memory, may be impaired.
All of these symptoms can affect a patient's ability to perform in school, work or simple daily activities.
Some AVMs are asymptomatic and will never even be diagnosed. Usually, the presenting symptoms help identify the part of the brain where the AVM is located. For example, if the AVM is in one of the brain's visual areas, there may be changes in eyesight. If an AVM is located in a part of the brain that controls motor skills, weakness on one side of the body may become apparent.
Diagnosis of AVMs
Diagnosis of AVM is confirmed with MRI.
CT angiogram and a formal cerebral angiogram.
These studies allow the team of experts to look at the exact size, location and architecture of an AVM in order to offer the best treatment options, taking into consideration the patient's symptoms, age, and treatment preferences.
Treatment Options for AVMs
Treatment options for AVMs have improved dramatically in the past decade.. The goal of treating an AVM is to completely close off the abnormal vessels, thereby curing the patient. This can be achieved in a variety of ways and requires a team of highly experienced specialists to provide the safest methods available posing minimal risks for individuals with AVMs.
Stanford University Medical Center has numerous options available for treating even the largest, most difficult AVMs, including:
- stereotactic computer assisted microsurgery
- embolization
- stereotactic radiosurgery with CyberKnife